Chances are most people know about osteoporosis, the condition where your bones become weaker due to a loss of bone density (how much bone tissue inside your bones) and break easily. These ‘fragility fractures’ are most common in the wrists, hips and spine. Spinal fractures can also cause the spine to curve – remember ‘Dowager’s hump’ – with accompanying height loss.

What is less wellknown is osteopenia, where your bone density is lower than the average adult but not low enough to be diagnosed as osteoporosis.

As the Royal Osteoporosis Society (ROS) website explains ‘Losing bone density is a normal part of ageing but this happens at different rates in different people. Many people have osteopenia in later life, as their bones get older. There’s a useful risk checklist for assessing what’s going on with your bones on the website here.

While osteopenia can increase your risk of breaking a bone, it doesn't mean you will need an osteoporosis medication. The ROS, which has long been supported by the Queen Consort, recommends positive lifestyle choices to help your bones stay stronger for longer. And osteopenia doesn't mean you will necessarily break a bone – although Jo had the bad luck to fracture both wrists, which proved a red flag warning to take good care of her bones.

She remembers: ‘There I was, enjoying my new shed, the first day of a week off. It was raining. I decided to go back down the sloping garden to the house, slipped on a plum and put all my weight down on my right wrist – and there went my holiday, spent having an operation on a shattered wrist.’ 

‘A year later in May 2012, a tiny, unmarked step outside someone's office sent me flying again – this time on to my left wrist. Cue another operation, on the day before Sarah's wedding (could the timing have been any worse?) With physio, both wrists are pretty much back to normal: I can do yoga, including downward dog, and carry heavy luggage or trays, all as they were before. (Yes, I have trouble taking off lids. But so does pretty much everyone I know.)’

‘I was told that my breaks revealed that I almost certainly had osteopenia. There was a question about drugs but researching the pharmaceuticals available, I decided to avoid them; I did not and do not like the idea of taking long-term medication. So I opted to go down a more naturopathic route, turning to pharmacist Shabir Daya at Victoria Health for his knowledge and experience.’ (Find Shabir’s comprehensive editorial on osteopenia here.)

‘Shabir suggested Bone Restore with Vitamin K2, which I have been taking religiously ever since. My stepson also took it during some dental work, where he was originally told the bone in his mouth wasn't strong enough to take an implant to replace a tooth he'd lost in a childhood accident. Three months on Bone Restore, and the dentist said it was fine to go ahead with the work.’

‘I also upped my intake of green, leafy veg – so good for bones – and other vitamin K-rich foods. I lift weights to help with bone-building and do resistant exercises in yoga (the aforementioned downward dog is said to be good for that), and walk my socks off. But always scanning, now, for trip hazards. And plums.'

Adding in calcium-rich dairy products and reducing alcohol and caffeine consumption are also good ideas. And, of course, not smoking.

Some medications (eg steroids and proton-pump inhibitors) increase the risk of osteopenia/osteoporosis so do talk to your doctor if you are taking those or other drugs that may weaken your bones. 

Early menopause and/or having ovaries removed are also risk factors that should prompt you to talk to your doctor.

So please, take great care of your bones. They’re important.

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